Would you self-pay for an operation?

Fionne · 02-11-2021 3:32pm #1

I'm 46 and have spinal stenosis, diagnosed after an MRI by a consultant in the Mater Private, Cork. Got a caudal epidural about a month ago now, it has helped a bit but I still absolutely cannot sit down - have now not been able to sit since early July, so can't drive, have to stand at work (office job), can't even sit long enough to eat.

Turns out my VHI policy doesn't cover me for any private hospitals so I had to pay €900 for the epidural injection. I rang my GP yesterday, asking to be referred to someone in a hospital I am covered for and he said he doesn't believe there is anyone else in this part of the country (County Cork) that could do a good job of operating on my back. The orthopaedic surgeons in the public system he says are up to their eyeballs in knees and hips and just don't have the expertise for the kind of surgery (spinal fusion) I need.

So what am I to do? I know that the 5-6 day stay in the Mater costs €1,000 per day so adding the cost of the actual operation onto that - I don't have that kind of money - I'm guessing but I reckon the whole thing could cost upwards of €10,000, maybe much more.

If I increase my health insurance cover when it's renewed next month so that I am covered for private hospitals, then there's a 2 year waiting period.

I can't bear the thought of having to wait 2 years with constant pain and being unable to sit down.

My GP says he's not even sure he can get me in to see a pain management doctor to get another of the epidural injections to keep me going, he said I'd be lucky to see anyone this side of Easter.

I understand the hospitals are busy, I get that there are people worse off and in more urgent need than me.....but.....PAIN!

Has anybody got any advice on what to do or where to go next? At the rate I'm going, I won't be able to continue working as it's just becoming so much of a struggle to stand all day, most of it on one leg as I can't bear the pain of putting my right leg on the floor.

Should I take a loan out for the operation? Would you do that if it was you? I'd sell my car, since I can't drive it anyway but it's still got 2 years of HP left.

Is it worth going for physio? I've been reluctant to as I can't cope with much more pain. I'm on pain meds but the GP won't increase them as he says it's amazing I've not already got stomach trouble from being on them since July.

SuperBowserWorld · 02-11-2021 8:09pm

At least pay for an appointment to see the best consultant you can for your condition. Maybe their are other options, stop gaps, treatments until your health cover covers it.

And ask them what the best thing to do is.

And get a realistic idea of the cost. Etc etc etc

Also, it might be possible to travel abroad for cheaper/better treatment.

Fionne · 03-11-2021 10:11am

https://www.boards.ie/discussion/comment/118108805#Comment_118108805

Yes, I have wondered if I should do that, go and see him again and get more information. My problem with travelling for treatment is that because I can't sit down (it is agonisingly painful) I can't travel far - I only manage as a passenger in the car if I recline the seat back. Apparently most people with my condition get relief from sitting but I would be the one to have it the other way around. 🙄

SuperBowserWorld · 06-11-2021 11:14am

Train to Dublin. Stand when you need to. And same on Dublin bus ?

Fionne · 10-11-2021 1:16pm

https://www.boards.ie/discussion/comment/118126550#Comment_118126550

Oh, I'd definitely get as far as Dublin if needs be and I've told my GP that. He still didn't seem hopeful of me getting an appointment with anyone though. Maybe I need a GP who will work harder for me.

SATSUMA · 11-11-2021 5:15pm

I've done this before. Find a consultant, ring the secretary for an appointment. The Mater Private is v expensive (the care was poor in my experience also) . Usually a consultant works in various hospitals and all will charge different prices. You can also negotiate with the hospital believe it or not! I think you should look into it for sure. You might actually be surprised at the varying costs. Best of luck

boombang · 11-11-2021 5:23pm

If the HSE can't do it you may be eligible for the treatment abroad scheme. It might not be fast to process, but could be worth considering. There's a clause about care being delivered in a timely manner. I hate to say it, but talking to your TD might help this along.

Fionne · 12-11-2021 12:27pm

https://www.boards.ie/discussion/comment/118151875#Comment_118151875

I did look into that, I'll need to have been through the public system first (you can't get referred for treatment abroad as a private patient) and my whole problem is not being able to get an appointment to see anybody in a public hospital. If I could just ring someone up that would be great but everything has to be done as a referral from the GP and to be honest, I've no idea if he's even tried.

boombang · 12-11-2021 6:21pm

https://www.boards.ie/discussion/comment/118155375#Comment_118155375

What a crazy system. The Treatment Abroad Scheme is meant to give faster access, but if you can't even get a public appointment you can't avail of the benefits?! I feel sick on your behalf. Maybe see if you can get the ball rolling on that process as it might be possible to get it going in parallel. I hope something sorts itself out soon.

Strumms · 15-11-2021 2:55am

Ultimately if it gets anymore out of hand and even if it doesn’t I’d present myself in a&e....you can sleep, appetite diminished, pain unbearable and can’t sit...

apache · 15-11-2021 1:26pm

https://www.boards.ie/discussion/comment/118167677#Comment_118167677

If it has to come to that do present yourself in A&E. That's terrible.

Fazorb · 15-11-2021 1:48pm

Have you read, The Wim Hof Method?

Fionne · 16-11-2021 12:19pm

https://www.boards.ie/discussion/comment/118169056#Comment_118169056

That tactic doesn't work I'm afraid, you still get sent home and told to make an appointment with a consultant. I know because my brother ended up in A&E with agonising pain in his leg because he'd been waiting so long to be seen for a cruciate ligament problem but he still got sent away from A&E and told to wait for his consultant appointment. He ended up self-paying for his operation to get it done.

A&E are busy enough without having to deal with non-life threatening issues coming in so I wouldn't really even consider doing that, as bad as I may feel. It just wouldn't be fair (and yes, I know, the whole system seems unfair). It's hard to fight my corner and kick up a fuss when there are people at risk of dying because of waiting lists or young children waiting for scoliosis operations.

Fionne · 16-11-2021 12:20pm

https://www.boards.ie/discussion/comment/118169165#Comment_118169165

I haven't but I am familiar with belly-breathing as I suffer with anxiety and panic attacks occasionally.

Fazorb · 16-11-2021 1:08pm

https://www.boards.ie/discussion/comment/118173983#Comment_118173983

Would highly recommend this book:

https://www.bookdepository.com/Wim-Hof-Method-Wim-Hof/9781846046292?ref=grid-view&qid=1637064389975&sr=1-1

Helped me with my constant lower back pain.

apache · 16-11-2021 9:47pm

https://www.boards.ie/discussion/comment/118173978#Comment_118173978

I thought you were in agonising pain. Are you still working?

MissGriff · 17-11-2021 3:54am

Hi OP, Has your GP even mentioned any neurosurgeons who he could refer you too? Neurosurgeons do spinal surgery, discectomies,fusions. Pretty much same training as orthopaedics but they do brains/ neuro all nerve system obviously too.

I say this as I had my back done by a neuro in CUH but by a private neurosurgeon with his rooms behind the hospital but who does his surgeries in CUH.

My health insurance was limited also but I was given the option by my great GP of an Ortho in a Dublin private hospital or the Neuro in Cork( I'm in Limerick). The appointment for Cork came thru within 3 days so went with him. Emergency situation started losing use of my leg ontop of severe pain for yrs.

Great surgeon, and lovely man to deal with.

I hope this might help.

Strumms · 17-11-2021 4:10am

https://www.boards.ie/discussion/comment/118173978#Comment_118173978

A&E though are not just for life threatening or seriously ill people...

about 5-10 % of people there are junkies for example who’ve been in a minor scrap, scrape or entanglement ...

go there.

PoisonIvyBelle · 17-11-2021 6:15am

I have and did, don't regret it at all.

The Mighty Quinn · 17-11-2021 6:43am

Personally I'd take the 10K loan. Repayments over 5 years are 199 a month with Bank of Ireland.

The financial pain would be more than worth it to have your health back. You can't live in that kind of pain for years.

Fionne · 17-11-2021 1:15pm

https://www.boards.ie/discussion/comment/118177681#Comment_118177681

I am in pain, though the caudal epidural has helped. I have no choice but to go to work, there is no sick pay in my job. I've had to switch to a standing desk which is utterly exhausting. I struggle, especially towards the end of the week because the pain gets worse. I arrived in this morning and spent the first 10 minutes crying because I was that sore from the 5 minute drive into work. If I lived any further away, I would absolutely have to give up work as I can barely tolerate sitting for that 5 minute journey.

Fionne · 17-11-2021 1:23pm

https://www.boards.ie/discussion/comment/118178779#Comment_118178779

My GP sent me to the guy in Mater Private as that was gonna mean I'd get seen sooner which was probably correct. I had the MRI and consultation and paid for the epidural injection. As I'm not covered by VHI for Mater Private, I rang the GP back and asked if he could refer me to someone in CUH or any other public hospital. He said there are two problems 1- getting an appointment as they are all so busy and 2- he said the guys doing back surgery in CUH are also doing hips and knees, etc so don't have the expertise to do the type of surgery I need.

I had an operation done 10 years ago by a guy in CUH as a private patient but it was a different issue (ruptured disc).

The public hospitals are so under pressure because of Covid, I think the GP is probably right in saying I'd be lucky to see anyone this side of Easter, let alone have any procedure done.

Fionne · 17-11-2021 1:27pm

https://www.boards.ie/discussion/comment/118178820#Comment_118178820

I may well have to do that if it comes to it, at the very least I'll have to find out the exact cost. A friend thinks I'd be mad though as if there was a complication I could end up owing a fortune if I had to stay in longer, etc. There's also an issue with not being paid while I'd be off work, when I had an operation 10 years ago I had to take my entire holidays for the year and then go back to work after 3 weeks when I'd been told to stay out at least 3 months. This operation is a much bigger deal so I could be out of work for much longer. I'd have to factor how I'd survive on the social welfare for that length of time and obviously wouldn't be able to afford loan repayments out of that either, I already have a car loan.

Redlim · 17-11-2021 1:54pm

I'd second what MissGriff said above and check out the neurosurgeon route. There are a few in CUH which you could call to check what their waiting times might be. Your condition may also mean you might get priority. Then just get your GP to refer you. Contact details listed in the link bit I think Prof O Sullivan is retired: https://cuhcpc.ie/services/neurological-surgery/

Was your previous disc surgery done by a neurosurgeon?

Fionne · 17-11-2021 3:15pm

https://www.boards.ie/discussion/comment/118180388#Comment_118180388

Yes, my previous surgery was done by George Kaar who I believe has also retired since.

Redlim · 17-11-2021 3:37pm

https://www.boards.ie/discussion/comment/118180964#Comment_118180964

Ok, might be no harm checking with one of the others. For example Chris Lim and Mahmoud Kamel are definitely still active.

MissGriff · 17-11-2021 8:51pm

https://www.boards.ie/discussion/comment/118180212#Comment_118180212

Your GP doesn't seem to pushed to advocate for you by sounds of it in the 2 points you made.

Of course they are all busy and especially now with Covid and cancellations of elective surgeries, but he and you should be exhausting all options no matter. And it sounds odd to me he says the surgeons in CUH don't have the expertise. People have stenosis and get fusions done all the time by these surgeons, unless your diagnosis is particularly unusual.

I completely understand the pain and how it can negatively affect how you perceive things and causes more worries, negativity etc but my advice is get on the phone, as Redlim said, check out the others, call directly,do your research, contact your health insurance provider and find out in detail what you are covered for specifically and where... sometimes just reading the the policy yourself is confusing and you can miss things.

Also re finances, if you have a mortgage, you will most likely have mortgage protection which will cover payments while out sick/recovering and with your situation ie.back surgery you just provide MRI evidence and surgeon sends a report.

Try not to panic,write notes and start making calls. Forget the GP not even trying to refer you to others, you need to insist he tries all options.

Mind yourself.

useless · 17-11-2021 9:16pm

https://www.boards.ie/discussion/comment/118182746#Comment_118182746

Re the comment on mortgage protection above, unfortunately this isn't true. The vast majority of people have mortgage protection, which pays back the bank if you die before the mortgage is paid off. A much smaller number of people have mortgage repayment protection as well as mortgage protection- this makes your repayments if you're ill or out of work. MRP is not standard and is expensive, hence most people don't have it. Even for those that do, the insurers go to great lengths to avoid paying out- if you do have MRP read the policy document to make sure elective surgery is covered.

OP, I would investigate the cost of private treatment and phone around some of the consultants offices to establish what their waiting lists are like. If it means borrowing the cost, surely its worth it if the pain you're experiencing is alleviated. Best of luck.

MissGriff · 17-11-2021 9:56pm

https://www.boards.ie/discussion/comment/118182855#Comment_118182855

No need to explain thanks, I know exactly what they are and the differences.I didn't say everyone has it and only basing my info on my own situation. I have one policy that covers both aspects and it's not very expensive. Yes they can be difficult to pay out however if covered for illness, evidence eg.mri and report they generally don't refute. Mine was paid with no question.

Anyway, it was a simple suggestion to help guide the OP to check out all the options they may have access too,medically or financially. I'm not here to dissect the ins and outs of mortgage protection.

Good luck OP?,

Gael23 · 18-11-2021 11:34am

Strongly advise against going abroad. What if there are complications along the way?

You can either upgrade your health insurance and wait or take out a loan and do it now. But I’d take this as a lesson and upgrade your VHI either way

Fionne · 19-11-2021 2:41pm

https://www.boards.ie/discussion/comment/118185006#Comment_118185006

I got my renewal from VHI yesterday so have been weighing up my options. It's going to add a lot of cost onto my policy to upgrade and there's the 2 year wait then to avail of it but I will definitely upgrade to at least be covered by private hospitals. Irish Life seem to include the Mater as a private hospital whereas VHI categorise them as High-Tech so I might even switch companies. It doesn't help my current problem as a 2 year wait just feels like a life sentence but at least if I ever need anything else from 2024 onwards, I'll be covered. I think it was because I had my last surgery done in CUH that I felt I was covered by just having the Private patient in public hospital box ticked, if only I'd known then what I know now.

Would you self-pay for an operation?

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